Disease, clinical research, pathology, drugs, treatment guidelines and protocols, diagnostic tests and procedure, regulations, reimbursement—these are everyday elements of the average physician, and they are typically not described as beautiful. Likewise, things like endless pages of HTML coding, Excel tracking sheets, and antivirus software are not appealing to most. But, in the right hands and minds, clinical data and technology tools can transform lives—whether by extending life, improving quality of life, or both. The practice of medicine requires a dedicated team with creative leaders in order to assemble these resources and deliver care that is not just effective, but also delivered with care and compassion to the very real people and families in need on the receiving end. The articles in this issue demonstrate how technology, data, and the art of medicine can come together in theory and in practice via clinical pathways.
The US Oncology Network, which includes approximately 1400 physicians spanning 25 states, began their journey into pathways in 2005 with the creation of Level I Pathways™. These were rolled out across The Network and were designed to identify choices that were not only clinically effective but also represented greater value compared with other options. The goal was to drive value in cancer care in the outpatient setting by ensuring delivery of consistent evidence-based care while eliminating unnecessary variation in treatment. In 2012, The Network partnered with the National Comprehensive Cancer Network (NCCN) to create Value Pathways powered by NCCN™. Aimee Ginsburg, PharmD, BCPS, and colleagues explain how this partnership enhances their pathways design (page 38). They also detail the technology supporting their pathways, which includes a shared electronic health system and integrated decision-support program standardized across The Network.
Value-based health care and reimbursement models are advancing; providers and facilities will need to demonstrate value to navigate these waters successfully. Quality measures, standardized best practices, and more efficient resource utilization will all need to be quantified. To preserve the “Art of Medicine,” physicians will be well served to take the lead on designing and implementing patient-centric pathways that also creatively integrate all the rules, regulations, and protocols required for value-based reimbursement. In their Perspectives article, Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, and colleagues suggest that the “Art of Medicine” requires developers to take an artist’s prerogative in crafting comprehensive care pathways (page 42). They assert that one needs to thoroughly understand all the rules established by the Food and Drug Administration, Centers for Medicare & Medicaid Services, and others to craft a clinical pathway that comprehensively optimizes care flow and stakeholder behaviors. This, they explain, is similar to how artists must first master all of the basics and conventions of their craft before they can innovate new and better creations.
Finally, you can also read about the Excellence in Pathways Award winners in this issue (page 23), which was announced at the virtual Oncology Clinical Pathways Congress last month. If you missed the Congress this year, you can still register for on-demand access to presentations and CME here bit.ly/OCPC2020.
